A1c — 9 things I got wrong before I got it right
A1c — 9 things I got wrong before I got it right — a position I have arrived at slowly and would like tested.
Substantial weight loss independently moves lipids, liver enzymes and several other markers. Attributing a change to a compound while losing weight is confounded by design.
My ApoB moved and I spent a fortnight convinced I knew why. The repeat six weeks later was back in range and I had changed nothing.
ApoB counts atherogenic particles rather than the cholesterol they carry, which is why it can diverge from LDL-C and why it is the addition most worth making.
If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.
best — the order this archive was captured in
Repeat testing before acting is standard practice for a reason: regression to the mean does a lot of work on single outlying values.
Push back: a value just outside a reference interval is a common finding in healthy people. It is a reason to repeat.
Push back: a value just outside a reference interval is a common finding in healthy people.
Disagreeing with this bit: that change is confounded by the weight loss itself and cannot be attributed.
Time of day, fasting state, hydration and recent exercise all move common markers. Standardising the draw conditions is free and it removes most of the apparent variability.
Time of day, fasting state, hydration and recent exercise all move common markers.
coldchain_karen is right that a reference interval is not a target. It is a description of a population.
Agreed on assay changes. A lab switching platforms between your draws is invisible unless you ask.
How many weeks between the two measurements?
This. Reference ranges are population intervals, not targets, and conflating them causes a lot of unnecessary alarm here.
How many weeks between the two measurements?
Adding the obvious one — take it to whoever ordered the panel. This board cannot read it for you.
Small fix — a reference interval is not a treatment target, and the post above uses them interchangeably.
the trend line matters more than any single value
draw at the same point in the week if you want comparability
ApoB is the one worth adding if you only add one
Nobody here can interpret your panel and this comment is not doing so. What a board can usefully do is help you ask better questions of somebody who can.
Nobody here can interpret your panel and this comment is not doing so.
Agreed — and standardising the draw conditions is the cheapest improvement available.
The confounding problem, stated plainly, because this board keeps stepping on it.
Substantial weight loss moves lipids, liver enzymes, insulin sensitivity markers and several others in its own right. If you are losing weight while taking something, any change in those markers has at least two candidate explanations and you cannot separate them from your own panel.
What you can do is standardise, take a baseline, keep the series long, and be honest in your posts about what is and is not attributable. The threads that say "this compound did X to my eGFR" almost never have the design to support the claim, mine included.
The confounding problem, stated plainly, because this board keeps stepping on it.
This is the sentence to read before anybody panics about a single value.
Brought the whole set to my clinician rather than one flagged value. Completely different conversation.
weight loss itself moves several of these independently
fasting state and time of day change more than people expect
Left up. It is a question about how to compare panels, not a request for interpretation.
one measurement is a point, two is a line, three is a trend
Have you taken this to whoever ordered it?
lab reference ranges are not treatment targets
assay method matters, especially between different labs
hydration status moves a surprising number of markers
same lab, same conditions, or you are comparing noise
Right, and weight loss itself moves several markers, so attribution is harder than these threads assume.
- 1Agreed on assay changes. A lab switching platforms between your draws is…10 comments in this branch · started by u/forest_plot_fiona
- 2Left up. It is a question about how to compare panels, not a request for…9 comments in this branch · started by u/lipid_panel_larry